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Individual

RUSSELL KEITH HO LEM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
9014 N 23RD AVE STE 8, PHOENIX, AZ 85021-2854
(602) 861-3339
(602) 861-3280
Mailing address
9014 N 23RD AVE STE 8, PHOENIX, AZ 85021-2854
(602) 861-3339
(602) 861-3280

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5492
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0933310
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
07/12/2006
Last updated
05/25/2016
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